Reducing Falls in the Emergency Department by Implementing a Virtual Tele Sitter

Purpose The purpose of this quality improvement (QI) project was to decrease falls by 25% in the emergency department by use of a portable tele-sitter device. Tele-sitter devices are remote virtual monitoring devices that are physically placed in a patient’s room to provide continuous audio and video surveillance of patients who are at a high-risk for falls. The goal is to decrease falls by utilization of a tele-sitter as opposed to a staff bedside sitter. Background This project was implemented in a non-profit 20 bed emergency department in the northwestern Houston, Texas area. Methodology A tele-sitter device was purchased by the organization for use by the emergency department. Baseline fall data was collected in the emergency department prior to implementation. Staff were trained on how to operate the portable tele-sitter and then utilized the device on high-risk fall patients. Fall events were tracked through the organizations internal reporting system. Pre- and post-implementation data were then compared through descriptive statistics to analyze changes in fall rates and safety sitter utilization. Results Post implementation descriptive statistics demonstrated a 43% reduction in falls compared to the pre-intervention data. Fall frequency decreased from one fall every four days to one fall every seven days post-implementation. Furthermore, the need for bedside safety sitters was decreased during the post-implementation period, resulting in an annual estimated cost savings of $15,200 for patient care assistants (PCAs) and $48,000 for registered nurses (RNs). Implications The comparison of pre- and post-implementation data demonstrated a significant decrease in fall rates, supporting the effectiveness of portable tele-sitter devices in the emergency department. The results of this QI project indicated that expanding the use of portable tele-sitter devices could further reduce adverse fall events in the emergency department. In addition, the reduction in bedside safety sitter usage directly translated into considerable cost saving, making tele-sitter devices a financially advantageous investment for hospitals.